Effect of Patent Ductus Arteriosus on Lower Extremity Blood Flow Velocity Patterns in Preterm Infants

Dale C. Alverson; Marlowe Eldridge; Marilyn Aldrich; Sher B. Werner; Pamela Angelus; William Berman

doi:10.1055/s-2007-1000008

American Journal of Perinatology, Table of Contents

Am J Perinatol 1984; 1(3): 216-222
DOI: 10.1055/s-2007-1000008

ORIGINAL ARTICLE

Effect of Patent Ductus Arteriosus on Lower Extremity Blood Flow Velocity Patterns in Preterm Infants

Dale C. Alverson, Marlowe Eldridge, Marilyn Aldrich, Sher B. Werner, Pamela Angelus, William Berman Jr.

University of New Mexico, Department of Pediatrics, and The Lovelace Medical Foundation, Department of Research, Albuquerque, New Mexico

Abstract

ABSTRACT

We used a 20-MHz, range-gated, pulsed Doppler device to measure noninvasively femoral artery blood flow velocity patterns in 24 preterm infants with patent ductus arteriosus (PDA). Mean spatial flow velocity and its temporal average were recorded by illumination of the entire flow stream. Peak systolic forward flow velocity (V_s), peak diastolic retrograde flow velocity (V_D), mean flow velocity (V_f), and the peak to peak-mean velocity ratio, (V_s-V_D)/V_f, were determined serially in each patient. The changes in the femoral flow velocity pattern preceded or coincided with other evidence of ductal left to right shunting. Prior to PDA closure, (V_s-V_D)/V_f averaged 14.1 and V_f averaged 4.4 cm/sec; after ductal closure, (V_s-V_D)/V_f fell to 3.7 (P < .001) and V_f rose to 9.1 cm/sec, more than twice the preclosure value (P < .001). Large diastolic reverse flow velocity vectors and low mean velocity correlated with large left to right PDA shunts estimated from other methods of assessment. The noninvasive femoral artery Doppler approach detects patency of the ductus early in life, reflects left to right shunting in diastole, and emphasizes the impact of the PDA on systemic blood flow.

Full Text